Organization
SPARKS FAMILY DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW ADAM SPARKS DMD (SOLE MEMBER/GENERAL DENTIST)
(860) 633-1809
Entity
Organization
Contact information
Practice address
622 HEBRON AVE STE 105, GLASTONBURY, CT 06033-5003
(860) 633-1809
Mailing address
622 HEBRON AVE STE 105, GLASTONBURY, CT 06033-5003
(860) 633-1809
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/03/2024
Last updated
01/03/2024
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